Willemain T R
Health Serv Res. 1977 Winter;12(4):396-406.
A model relating bed supply and utilization is presented in the context of the match between need and service, which is controlled by the screening process that allows or denies access to beds. The conventional cost-minimization approach to certification of need, that of seeking to reduce inappropriate use, is contrasted with a service-delivery approach that seeks to promote appropriate use of facilities. The model expresses the quality of the screening process and the sensitivity and specificity of utilization in terms of bed supply, utilization, and need for service, which allows it to be used for needs assessment. The model is applied to data on supply and use of beds in Massachusetts skilled nursing facilities, with screening quality estimated by Monte Carlo methods; the results suggest that need and bed supply are positively associated and that the regional variation in skilled-nursing beds in Massachusetts may reflect real variations in need.
在需求与服务匹配的背景下，提出了一个关于床位供应与利用的模型，该匹配由允许或拒绝使用床位的筛选过程控制。传统的需求认证成本最小化方法，即试图减少不当使用，与寻求促进设施合理使用的服务提供方法形成对比。该模型根据床位供应、利用情况和服务需求来表达筛选过程的质量以及利用的敏感性和特异性，这使其可用于需求评估。该模型应用于马萨诸塞州专业护理机构床位供应和使用的数据，通过蒙特卡罗方法估计筛选质量；结果表明需求与床位供应呈正相关，并且马萨诸塞州专业护理床位的区域差异可能反映了实际需求的差异。
